Tambaqos wevis mitoveba da prevencia

Tssu-is medicinis fakultetiVI kursi28-e jgufi

xatia eJiSvili

2010w.

nikotinuri damokidebuleba aris swrafva Tambaqos produqtebis mimarT, romelic gamowveulia Tambaqos Semadgeneli ZiriTadi fsiqoaqtiuri ingredientis nikotinis moqmedebiT. nikotini fizikurad da fsiqologiurad miCvevas iwvevs. es yvelaze didi gavlenis mqone damokidebulebis gamomwvevi preparatia msoflioSi da misi moxmareba asocirebulia janmrTelobisTvis bevr seriozul riskTan.

• sigaretisgan, sigarisgan da Cibuxisgan gamonabolqvi Seicavs 4000-mde qimiur nivTierebas, romelTaganac 40-ze meti cnobilia, rogorc kibos gamomwvevi (kancerogeni). mwevelebs gulis paTologiis, insultis da kancerogenuli daavadebebis ganviTarebis mniSvnelovnad maRali maCvenebeli aqvT.

• sigaretis moweva, roca is Cvevad iqceva,

Seesabameba nivTierebebze damokidebulebis samedicino kriteriumebs.

•  

epidemiologia jandacvis msoflio organizaciis janmo-s monacemebiT, msoflioSi daaxloebiT 1.3 bilioni regularuli mwevelia  globalurad iTvleba, rom TiTqmis 5-jer meti mamakaci eweva, (48%) vidre qali (10%). amJamad, 5.4 milioni adamiani kvdeba yovelwliurad msoflioSi Tambaqos moxmarebis Sedegad - saSualod, 1 adamiani yovel 6 wamSi,.is warmoadgens risk-faqtors 8-dan 6 daavadebisa, romlebic sikvdilis wamyvan mizezebis ricxvSia msoflio maStabiT. monacemebi saqarTvelosTvissadReisod Tambaqos moixmars qveynis mosaxleobis daaxloebiT 37-40%. mamakacebs Soris mwevelia 50-65%, xolo qalebs Soris 16-22%. saqarTveloSi wlis ganmavlobaSi Tambaqos mavne zemoqmedebis Sedegad gul-sisxlZarRvTa paTologiebiT avaddeba 100 aTasamde Tambaqos momxmarebeli.“pasiuri wevis” Sedegad iRupeba 4000-mde udanaSaulo adamiani.

  

etiopaTogenezi

mwevelobis dawyebasa da mis SenarCunebaze moqmedi ZiriTadi faqtorebia:socialuri zegavlena: reklama, fasi, xelmisawvdomoba, TanatolTa zewola, TviTSefaseba da sxv.

interpersonaluri zegavlena: ojaxis wevrebi, megobrebi, popularuli adamianebi, maswavleblebi da sxv.

personaluri zegavlenebi: warmodgenebi, ra SeuZlia gamoiwvios mowevam. mag. wonis kontroli, damSvideba, TviTdajerebis momateba, siamovneba, momxibvleloba da a.S. nikotinis Tviseba, gamoiwvios miCveva da fizikuri simptomebi, aixsneba nikotinis kavSiriT cns-Si qolinergul da nikotinur receptorebTan, Tirkmelzeda jirkvlis tvinovan SresTan, nerv-kunTovan sinafsebTan da vegetatiur gangliebTan. mezolimburi sistemis dofaminerguli neironebis stimulacia da neiroadaptacia ganapirobebs nikotinis mimarT midrekilebas, damokidebulebis, tolerantobis da aRkveTis sindromis ganviTarebas.

nikotinis moxmarebasTan mWidrod dakavSirebuli daavadebebi

sasunTqi sistemaemfizema, qronikuli bronqitebi, asTma da filtvebis qronikuli obstruqciuli daavadebebi

gul-sisxlZarRvTa sistema gulis iSemiuri daavadeba

cns insulti

kancerogenuli daavadebebifiltvebis, yelis, saylapavis, mkerdis, Sardis buStis kibo

sxva qronikuli tkivilis sindromi

nayofis wonis Semcireba

diagnostika

Tambaqos moxmareba unda ganixilebodes, rogorc seriozuli samedicino problema.pirveladi jandacvis eqimma anamnezuri monacemebis Sekrebisas aucileblad unda gansazRvros pacientis mier Tambaqos moxmarebis faqti. yvela pacients unda hkiTxoT, eweva Tu ara Tambaqos da regularulad SeavsoT Tambaqos moxmarebis statusis amsaxveli dokumenti. strategia TiToeul pacientTan dakavSirebiT gansxvavebulia da individualurad unda SemuSavdes. klinicistebma unda hkiTxon bavSvebs da mozardebs Tambaqos moxmarebis Sesaxeb da kargad auxsnan maT, Tu ra mniSvnelovania Tambaqos mowevisgan Tavis Sekaveba

sadiagnozo kriteriumebi

nikotinuri damokidebulebis qveS igulisxmeba fsiqikuri da qceviTi aSlilobebi, romlebic nikotinis miRebiTaa gamowveuli da zustdeba kodiT F17. damokidebulebis sindromi, dsk me-10 gadasinjvis mixedviT ismeba, Tu 1 wlis manZilze 6 niSnidan aReniSneba 3 an meti: • fsiqoaqtiuri nivTierebis miRebis kompulsiuri survili; • tolerantoba; • kontrolis dakargva nivTierebis miRebisas, misi moxmarebis dawyebis, damTavrebis an moxmarebis xasiaTis TvalsazrisiT; • aRkveTis sindromis formireba; • moxmarebis gagrZeleba miuxedavad damRupveli Sedegebisa; • alternatiuli interesebis progresuli ukuganviTareba fsiqoaqtiuri nivTierebis miRebis sasargeblod. 

mkurnaloba konsultirebis da qceviTi Terapiis tipebi: gansakuTrebiT kargi SedegebiT (TambaqosTvis Tavis danebebis maRali sixSiriT) gamoirCeva konsultirebis da qceviTi Terapiis Semdegi ori tipi: 1 .mwevelebisTvis praqtikuli treningis Catareba (problemis mogvarebis unar-Cvevebi/unar-Cvevebze treningi), 2 mxardaWera da gamxneveba, rogorc mkurnalobis Semadgeneli nawili. klinicistebma aucileblad unda urCion yvela mwevel pacients, Sewyviton moweva, radgan mtkicebulebebma aCvena, rom eqimis rCeva zrdis mowevis Tavis danebebis sixSires. 

 

medikamenturi mkurnaloba

 

• bupropion-SR• nikotinis Semcveli saReWi

rezini• nikotin-inhalatori• nikotinis Semcveli nazaluri

sprei• rimonabandi• vareniklini• klonidini• notriptilini

im pacientebisTvis, romlebic Relaven mowevis Sewyvetis Semdeg wonaSi momatebis Taobaze, yvelaze gamarTlebulia bupropion SR an nCT (kerZod, nikotinis saReWi rezini an nikotinis sawuwni abi). dadgenilia, rom es preparatebi aferxeben wonis matebas mowevis Sewyvetis Semdeg.

prognozi Tu saswrafo zomebi ar iqneba miRebuli, 2030 wlisTvis 8 milioni adamiani gardaicvleba yovelwliurad. TandaTan, qalebsa da mamakacebs Soris arsebuli sxvaoba Semcirdeba, radgan mwevel qalTa raodenoba izrdeba, rac iwvevs qalebSi Tambaqos mowevasTan dakavSirebuli daavadebebis tvirTis zrdas.

gmadlobT yuradRebisTvis!